FOR SECURE WEB PAGE, CLICK HERE.

Secure online payments accepted.

Click here to go to main web site:

COMPLETE THE APPLICATION BELOW AND UPON RECEIPT I WILL PERSONALLY CALL YOU.

PLEASE NOTE:  It will take 20 days, from the date your MC number is assigned to obtain a copy of your authority, providing your BOC-3 and insurance is on file.  THE 20 DAYS IS A REGULATION AND THERE IS NO POSSIBLE WAY YOU CAN GET STARTED ANY SOONER EVEN THOUGH THERE ARE WEB SITES SAYING THEY CAN GET YOU STARTED IN LESS TIME.

Who is Rex Evilsizor???

Rex is a retired ICC (Interstate Commerce Commission) Investigator (Special Agent) with almost five (5) decades in transportation.  Rex received his Transportation Practitioners license and is also a Licensed Insurance Agent.

We have a total "In-House" service for all your transportation needs.  Why go anywhere else.

Check out my articles at: http://www.layover.com/owneroperator/rexpert/

Also check out my article in the Internet Truckstop Magazine called "IT"

COMPLETE THE APPLICATION BELOW AND UPON RECEIPT I WILL PERSONALLY CALL YOU.

 

 

        
   

Get your own FMCSA Authority
Only $499 - includes...
* FHWA filing fee  MC number
* US DOT filing  USDOT number for carriers
* Process Agents (blanket coverage-No Annual Fee)
 *We can also register with the State - UCRA

*I can even help you with your insurance needs.

Complete package - NO HIDDEN COSTS!
For further assistance call us at 866-382-6638

 BROKER  Authority Application

 


Broker:
Broker (except Household Goods) 
Broker (of Household Goods)

APPLICANT NAME *Required

DOING BUSINESS AS: 

SSN or EIN: 

PHYSICAL ADDRESS, CITY, STATE & ZIP CODE

MAILING ADDRESS, CITY, STATE & ZIP CODE

TELEPHONE NUMBER:  
 * Required   		 FAX NUMBER : 
 

 EMAIL ADDRESS:
* Required

BUSINESS TYPE: 
Individual;
Partnership;
Corporation (State - );
LLC (State -

Name of Owner/Officer: * Required
 

Title of Owner/Officer:
If other, please specify:

 

YOU MUST ANSWER "YES" OR "NO" TO THE FOLLOWING QUESTIONS:

1. Do you have ICC/FHWA Authority now?
(Yes) or (No)  MC#

2. Do you or anyone connected with company now have interest in any other ICC/FHWA regulated carrier or broker?
(Yes) or (No) 
If "YES" list Name of Company
and MC#

3. Have you ever had a DOT Safety Audit?
(Yes) or (No) 

PRESENT DOT NUMBER (IF ANY)
  		Safety Rating (If any) 

4. (Yes) or (No) Have you been convicted after September 1, 1989, of distribution or possession of a controlled substance?

5. (Yes) or (No) Will your operations be conducted in compliance with the DOT rules and regulations or safety?

6. (Yes) or (No) Are you domiciled, owned, or controlled by persons in Mexico?

7.  (Yes) or (No) Are you a US Citizen?

Payment Method: *required

Credit Card Information

Type:  

Amount Charged:

Card Number: Expiration:

Security Code: (4 digits for AMEX; 3 digits for all other card types)

Cardholder Name:

Indicate by typing "Yes" that Cardholder authorizes Rex Evilsizor to charge $499 to my credit card for my motor carrier and/or broker and/or freight forwarder authority.

Billing Street Address:

Billing Zip Code:

All information is strictly CONFIDENTIAL and is NOT SHARED with anyone!  There is no obligation.

Do you want information about Surety Bond; Trust Fund, and/or Contingency Cargo Insurance.

How did you hear about us?

((NOTE: If this form does not "Submit Application" properly, go to the top left of this page and click on FILE; then click on SEND; then click on PAGE BY E-MAIL; and e-mail to: rex@rexevilsizor.com .))

 (((NOTE:  If this does not work, please call Rex at 866-382-6638.)))